Breast cancer is a woman’s bogeyman. Most women know others who’ve had the disease or died from it. And most are confounded that their breasts, which nurtured their children, can also offer up illness, disfigurement and even death. Such feelings make it easy to believe incorrect information that can heighten fear. Below are common breast cancer myths and the facts that debunk them…

Myth #1: Breast self-examination is the best way to detect breast cancer.

Getting a high-quality mammogram read by an experienced radiologist is the most reliable way to detect breast cancer. For starters, a mammogram can detect breast cancer before a woman is likely to feel a lump. And because more and more women are getting mammograms – two-thirds of women over age 40 have had a mammogram in the last two years – most cases are diagnosed at early stages of the disease.

A doctor may also recommend magnetic resonance imaging (MRI) if:

A woman’s breast tissue is particularly dense

She has fibrocystic disease or implants that may impair mammogram interpretation

A mammogram reveals a suspicious area

Are breast exams worthless? Not in the least. Breast exams still reveal about 25% of breast cancers; mammography about 35%; and a combination of examination and mammography about 40%. So performing routine breast self-examination remains important.

Myth #2: If you have a family history of breast cancer, you will probably get the disease.

Although family history is certainly a factor, the risk of contracting the disease is still quite low. In fact, about 80%-90% of women who get breast cancer are the first in their families to have it. Approximately 10%-15% of breast cancers may be genetic, with about one-third of those due to inherited gene mutations called BRCA1 (breast cancer gene 1) and BRCA2 (breast cancer gene 2).

These mutations are more common among certain ethnic and geographic groups, including Eastern European Jews, Norwegians, the Dutch, and Icelanders. If one of your relatives, especially your mother or sister, has had breast cancer before age 50, it’s more likely that you may have one of these genes. Women with genetic mutations tend to develop breast cancer before they are 50. The American Cancer Society suggests that women with a family history should start getting mammograms and MRIs at age 30. Women not at high risk should begin having mammograms at age 40.

Myth #3: Birth control pills cause breast cancer.

Research has not yet pinned down the relationship of birth control pills to breast cancer. So far, studies show conflicting results. Early studies used pills with higher concentrations of hormones (estrogen and synthetic progestin) than are commonly prescribed now. (See related article: Breast Friend or Foe? The Truth About Estrogen)

Other studies have found that extended use of the pill may be associated with increased risk. One analysis of multiple studies found that after 120 months on the pill, users were slightly more likely to get breast cancer than non-users. However, 10 years after these women discontinued the pill, their breast cancer risk returned to normal.

The most recently published (9/11/07) and largest study to date does not demonstrate any increased risk of breast cancer from the use of birth control pills. However, women with a family history of breast cancer related to the BRCA genes should consult their physicians to consider whether birth control pills may up the risk.

Myth #4: High-fat foods cause breast cancer.

Scientists have not yet established a link between breast cancer and eating foods rich in fat, although a few studies do suggest an association. For example, when the National Cancer Institute (NCI) asked post-menopausal women about the foods they ate, and followed their diets for more than four years, they found a slightly increased risk of breast cancer among the women whose diets were highest in fat compared to those who ate the least fat.

Interestingly, the NCI researchers found that the type of fat – such as saturated fat – the women ate did not seem to matter, despite that finding in other studies. The evidence is clearer linking breast cancer to both obesity after menopause and weight gain as an adult.

Myth #5: A diet full of fruits and vegetables will help prevent the recurrence of breast cancer.Limited studies suggest that eating lots of vegetables and fruits may protect against breast cancer. But the question remained whether fruit and vegetables could decrease the risk of recurrence in breast cancer survivors.

Consequently, another study looked at the diets of women successfully treated for breast cancer. Half of the more than 3,000 women in the study were assigned a diet loaded with veggies, fruits and fiber. They could eat meat but no more than 15%-20% of their diet could come from fat. The other women received only educational materials about diet. Over the seven-year study period, cancer recurred with the same frequency in both groups and neither group lost weight. This suggests that the mega-veggie group did eat their vegetables, but probably fudged on the fat.

However, a number of studies have suggested that antioxidants, compounds in fruits and vegetables, appear to lower the risk of many chronic diseases, including some cancers. So a plateful of nature’s bounty every day can’t hurt and just may help. (See related article: When Breast Cancer Comes Back)

Myth #6: If I didn’t inherit the breast cancer gene, I won’t get breast cancer.

Approximately 5%-10% of breast cancers are caused by genetic mutations. BRCA1 and BRCA2 are the most common ones linked to breast cancer, but at least six others may be involved. People with mutations in these genes have a high risk of developing breast and ovarian cancer. And the presence of either of these mutations creates a 40%-80% risk of contracting breast cancer.

So how do you estimate the likelihood of having a genetic mutation? First, women with genetic mutations often develop breast cancer before they are age 50. But the older you are, the greater the chance of developing breast cancer. So if you are older than 50 and do not have breast cancer, your odds of a genetic mutation are lower (but not zero).

Next, you would likely have a mother, sister or daughter who has had breast cancer before age 50 or ovarian cancer at any age. If a woman in your family has had both breast and ovarian cancer or cancer in both breasts, an inherited mutation more likely runs in your family. You are also at higher risk if you are of Eastern European Jewish descent. Male breast cancer in the family also suggests genetic mutations.

However, the risk of genetic mutations is still quite low, even in higher-risk groups. For example, in women who have breast cancer before age 45 and a family history of breast cancer, the incidence of the BRCA1 mutation is still only 7.2%. In other words, such women still have a greater than 90% chance of not having the mutation.

If you wish to be tested for genetic mutations, speak with your physician who may refer you to a genetic counselor. The test is a simple blood test that typically takes a few weeks to process. A genetic counselor can also assist you in interpreting the results.

Myth #7: Prophylactic mastectomy guarantees that I will not get breast cancer.

Prophylactic, or preventive, mastectomy is a procedure offered to high-risk women to reduce their likelihood of developing breast cancer. A surgeon removes one or both breasts and examines the tissue to rule out cancer. In carriers of either the BRCA1 or BRCA2 mutations, the risk of developing breast cancer may be 40%-80%.

If you and your doctor decide to proceed with a prophylactic mastectomy, it may reduce your risk by 90%. However, breast tissue may be left behind by even the most careful surgeon. Breast tissue extends up toward the neck, under the arms and to the chest wall. No one can assure you that all the breast tissue is removed, and any remaining tissue carries the risk that a cancer may occur. If you do have a mastectomy, your doctor will continue to screen you to ensure that cancer does not occur or is caught early.

Myth #8: One in every eight women will get breast cancer.

This misleading statistic is commonly cited. The figure of one in every eight women is the cumulative risk over an 85-year lifespan. It does not mean that one in every eight women have breast cancer or will get breast cancer. Only if all women lived to 85 would one in eight develop breast cancer.

Because the average American woman’s lifespan is less than 85 years, their lifetime risk of getting breast cancer is 8% (about 1 in 12). The lifetime risk of dying from breast cancer is 3.6%.

The incidence and mortality rate of breast cancer varies widely based on ethnicity. White women have the highest incidence of breast cancer; Native Americans the lowest. African-American women have the highest mortality rate. Asian-Americans and Pacific Islanders are least likely to die from breast cancer.

Myth #9: Trauma to the breast can cause cancer.

Breasts are subject to many types of trauma but no evidence suggests that any of it causes breast cancer.

One such myth started in 1995 with the publication of Dressed to Kill: The Link Between Breast Cancer and Bras by Sydney Ross Singer and Soma Grismaijer. The authors proposed that bras – underwire bras in particular – suppressed the lymphatic system (a natural drainage system around the cells and organs of the body), causing toxins to accumulate around the breast. The toxins would make the breast vulnerable to certain diseases, including cancer. But the authors failed to take into account any other genetic, environmental or behavioral risk factors. Medical experts have discredited this theory.

Another myth is that injury or trauma (including heavy petting!) to the breast may cause cancer. Injury can cause some physical changes, but cancer is not one of them. Bruising and non-cancerous lumps are common. And the repair of an injury may produce scar tissue that can feel like a lump and sometimes look like cancer on a mammogram. But further study or a biopsy can clear up the confusion.

Myth #10: I shouldn’t have a mammogram because they can cause breast cancer.

Some scientists and consumer groups are concerned that the radiation exposure in a mammogram could be increasing breast cancer risk. They suggest that as much as one additional breast cancer case results from every 10,000 mammography procedures. And studies have shown that breast tissue is sensitive to the effects of radiation, particularly in younger women. However, most breast cancer specialists consider mammograms a safe imaging procedure with benefits that far outweigh the risks. (See related article: 4 Breast Cancer Breakthroughs)

Mammograms use extremely low doses of radiation. Although they are higher than those used for a standard chest X-ray, they fall well within established safety levels. And no studies clearly link mammograms and breast cancer. Abundant evidence indicates that mammograms save lives through early detection.

Because of the concern about excess radiation exposure, women undergoing mammograms should make certain they are seen in an FDA-certified facility (the certificate should be on display), preferably one that is also accredited by the American College of Radiology. This will help ensure that the X-ray equipment is up to date and properly calibrated and tested.

What’s Your Breast Cancer Risk?

The biggest risk factor for developing breast cancer is simply being a woman, though a small percentage of men develop it, too. Fortunately, with better screening processes for early detection, breast cancer doesn't have to be fatal. Find out how at-risk you are with this breast cancer quiz.

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